Improvement of severe systemic sclerosis-associated gastric antral vascular ectasia following immunosuppressive treatment with intravenous cyclophosphamide

J Rheumatol. 2009 Aug;36(8):1653-6. doi: 10.3899/jrheum.081247. Epub 2009 Jul 15.

Abstract

Objective: We describe 3 patients with systemic sclerosis (SSc) with severe, transfusion-dependent gastric antral vascular ectasia (GAVE) refractory to laser ablation who showed remarkable clinical and endoscopic improvement following intravenous (IV) pulse cyclophosphamide (CYC) treatment.

Methods: Review of clinical records and upper gastrointestinal endoscopy images from 3 patients with SSc and severe GAVE before and after treatment with IV pulse CYC.

Results: IV CYC was followed by improvement and stabilization of hemoglobin levels, and marked reduction in blood transfusion requirements and the number and frequency of endoscopic laser treatments.

Conclusion: IV pulse CYC immunosuppression was followed by remarkable clinical and endoscopic improvement of SSc-associated GAVE.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Transfusion
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage*
  • Female
  • Gastric Antral Vascular Ectasia / drug therapy*
  • Gastric Antral Vascular Ectasia / etiology*
  • Gastric Antral Vascular Ectasia / surgery
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Infusions, Intravenous
  • Laser Therapy
  • Middle Aged
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / drug therapy*
  • Severity of Illness Index

Substances

  • Immunosuppressive Agents
  • Cyclophosphamide